NPI | 1497955975 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PR 26451) |
Additional Taxonomies | 208000000X Pediatrics (Licence: PR 25843) |
Enumeration Date | 2007-07-23 |
Last Update Date | 2007-08-11 |